基于数据挖掘的穴位贴敷治疗痛经取穴与用药规律

Acupoint Selection and Medication Rules of Application Therapy in Treatment of Dysmenorrhea:A Study Based on Data Mining

目的:探讨穴位贴敷治疗原发性痛经的用药与取穴规律。方法:检索国家知识基础设施数据库(CNKI)、中国生物医学文献数据库(CBM)、中国学术期刊数据库(CSPD)及中文科技期刊数据库(CCD)及Pubmed、Cochrane library、the Web of Science、Embase中穴位贴敷治疗原发性痛经的临床文献,检索时间自建库到2022年2月15日。使用Microsoft Excel 2016、SPSS Statistics 25.0、SPSS Modeler 18.0对数据进行描述性分析、聚类分析及关联规则分析。结果:共纳入70篇文献,包括81味药物和24个穴位。频次统计显示,使用频次前5位的药物为延胡索、肉桂、细辛、当归及川芎,药味以辛、甘、苦居多,药性以温、热为主。使用频次前5位的穴位为关元、神阙、中极、三阴交及子宫,以任脉腧穴为主。聚类分析发现,高频药物与腧穴均可聚成5类,可作为贴敷药物与腧穴处方辨证使用。关联规则显示,高频药物得出关联规则16条,核心处方为延胡索、当归、细辛、肉桂、吴茱萸、川芎;选穴得出关联规则29条,核心处方为神阙、关元、三阴交、子宫、气海、中极。结论:穴位贴敷治疗原发性痛经选穴以局部配穴为主,配合远端取穴;用药以活血药、温里药、理气药及补血药为主。用药与选穴规律体现了调理冲任胞宫气血、标本兼顾的治疗原则。

Objective:To explore the acupoint selection and medication rules of application therapy in treatment of primary dysmenorrhea(PD).Methods:The articles on the clinical research of PD treated with application therapy were retrieved from China National Knowledge Infrastructure(CNKI),Chinese Biomedical Literature Database(CBM),China Science Periodical Database(CSPD),Chinese Citation Database(CCD),Pubmed,Cochrane Library,Web of Science,and Embase from the inception of databases to February 15,2022.Microsoft Excel 2016,SPSS Statistics 25.0,SPSS Modeler 18.0 were employed to perform descriptive analysis,cluster analysis,and association analysis on the data.Results:A total of 70 articles were collected,including 81 herbal medicines and 24 aucpoints.It was found in frequency analysis that the top 5 herbal medicines in frequency of use were Rhizoma Corydalis,Cortex Cinnamomi,Radix et Rhizoma Asari,Radix Angelicae Sinensis,and Rhizoma Chuanxiong,and the herbs used were mostly pungent,sweat and bitter in flavors,and mainly warm and heat in nature.The top 5 acupoints in frequency of use included Guanyuan(CV 4),Shenque(CV 8),Zhongji(CV 3),Sanyinjiao(SP 6),and Zigong(EX-CA 1),and they were mainly concentrated in conception vessels.According to cluster analysis,high-frequency herbal medicines and aupoints both clustered into 5 categories,which can be used in application medicines and acupoint prescriptions based on syndrome differentiation.Association analysis indicated that 16 association rules were obtained for high-frequency medicines,and the core prescriptions were Rhizoma Corydalis,Radix Angelicae Sinensis,Radix et Rhizoma Asari,Cortex Cinnamomi,Fructus Evodiae and Rhizoma Chuanxiong;29 association rules were obtained for acupoint selection,and the core prescriptions were Shenque,Guanyuan,Sanyinjiao,Zigong,Qihai and Zhongji.Conclusion:The acupoint selection rule in treatment of PD with application therapy was local acupoints being predominant combined with remote acupoints,and the medicines for activating blood,warming interior,regulating qi,and tonifying blood were mainly used.The rules of acupoint selection and medication reflected the treatment principle of regulating qi and blood in thoroughfare and conception vessels and uterus,as well as simultaneous treatment of both manifestation and root cause of disease.